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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
S
S
F
I
U
G
I
N
W
Y
G
P
U
P
M
L
U
Z
Y
S
E
S
W
L
B
W
N
E
E
Y
E
E
I
U
Z
K
S
V
S
L
T
R
R
S
C
P
E
A
C
O
B
P
A
U
O
I
Q
S
E
G
R
A
H
C
D
N
P
L
A
C
E
D
I
R
I
E
G
N
C
F
X
G
S
E
B
D
C
A
U
R
M
C
V
J
S
U
E
O
I
I
E
E
A
Q
C
N
R
M
R
D
R
H
R
E
D
I
V
O
R
P
V
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